How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $154.88 | Facility | None | $89.13 | $89.13 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $97.72 | Professional | None | $75.86 | $93.33 | $97.72 |
BCBS Kansas Setting Facility Modifier None Typical Low $109.65 Median $114.82 Typical High $114.82 | Facility | None | $109.65 | $114.82 | $114.82 |
BCBS Kansas Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $218.78 Typical High $295.12 | Facility | None | $85.11 | $218.78 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $95.50 | Facility | None | $70.79 | $83.18 | $95.50 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $100.00 | Professional | None | $89.13 | $97.72 | $100.00 |
United Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $102.33 | Professional | None | $91.20 | $97.72 | $102.33 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $46.77 Typical High $48.98 | Professional | 52 · Reduced service | $38.02 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.62 Typical High $19.50 | Professional | 53 · Discontinued | $15.14 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.13 Typical High $14.79 | Professional | 55 · Aftercare only | $11.48 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.33 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.59 | $9.33 | $9.77 |
Where Kansas sits
The same service costs 2.9 times more in Arizona than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kansas· 3rd of 51
$100
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.